Evidence mapPaperPMID 42161421Full record

SynthesisOpen heart2026

Prognostic value of CT-derived fractional flow reserve for major adverse cardiovascular events in patients with suspected or known coronary artery disease: a systematic review and meta-analysis.

Shankar Biswas, Yashasvi Srivastava, Ayman Hamadttu

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Shankar BiswasDepartment of Internal Medicine, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine Sb740927@gmail.com.ORCID http://orcid.org/0009-0005-2421-3953
Yashasvi SrivastavaDepartment of Internal Medicine, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
Ayman HamadttuDepartment of Internal Medicine, College of Medicine, Sudan University of Science and Technology, Khartoum, Sudan.ORCID http://orcid.org/0009-0001-1066-7648

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFractional flow reserve derived from CT (FFR-CT) enables non-invasive functional assessment of coronary stenoses in patients with suspected or known coronary artery disease, but evidence regarding its prognostic value remains fragmented. We conducted a systematic review and meta-analysis to quantify the association between abnormal FFR-CT and major adverse cardiovascular events (MACE), updating the 2022 meta-analysis by Nørgaard

resultsTwenty-two studies with 20 067 patients were included, representing a fourfold increase from the prior meta-analysis. Follow-up ranged from 12 to 120 months. Patients with FFR-CT ≤0.80 had significantly higher MACE risk (HR 3.94; 95% CI 2.92 to 5.31; p<0.0001) with substantial heterogeneity (I²=79.9%). However, restricting to hard endpoints (death/myocardial infarction; k=6) yielded HR 3.28 (95% CI 2.25 to 4.79) with zero heterogeneity (I²=0%). No significant differences emerged across FFR-CT technologies (p=0.812), including HeartFlow, machine learning and deep learning algorithms. Trim-and-fill analysis suggested possible publication bias, with adjusted HR 2.35. GRADE certainty was moderate.

conclusionsAbnormal FFR-CT is associated with nearly fourfold increased risk of MACE in patients with suspected or known coronary artery disease, with consistent prognostic value across technologies. The absence of heterogeneity for hard endpoints supports FFR-CT as a reliable prognostic marker. These findings address the evidence gap identified by current guidelines regarding FFR-CT prognostic utility. PROSPERO REGISTRATION NUMBER: CRD420261276897. CLINICAL TRIAL NUMBER: Not applicable (as this is a Systematic Review and Meta-Analysis and not a Clinical Trial).

Indexed as

Computed Tomography AngiographyCoronary Artery DiseaseFractional Flow Reserve, MyocardialTomography, X-Ray ComputedCoronary AngiographyHumansPredictive Value of TestsPrognosisRisk AssessmentComputed Tomography AngiographyCoronary Artery DiseaseMeta-Analysis

Identifiers

PMID42161421
PMCPMC13202077

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.